Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Glossary 259

intracellular space Inside the cells of body tis- sues. intracranial Inside the skull (cranium). intravenous fluids (IV) Fluids infused directly into the circulatory system through a hypodermic needle inserted into a vein, usually used to tempo- rarily increase the volume of circulating blood or restore fluid lost to sweating or diarrhea. intubation Placing an endotracheal tube or Combitube device into the trachea. involuntary guarding Refers to abdominal mus- cle spasm to protect the abdomen from painful movement. Considered a sign of peritoneal irri- tation. ischemia Local loss of perfusion due to swelling, deformity, or obstruction; can result in infarction. level of consciousness (LOC) Describes the level of brain function in terms of responsiveness to specific stimuli: (The AVPU Scale) A = Awake, V = responds to Verbal stimuli, P = responds to Painful stimuli, U = Unresponsive to any stimuli. ligaments Tough connective tissue joining bone to bone across joints. local effects Effects that are restricted to the immediate area of injury or infection (versus systemic effects). local toxins Toxins that affect only the immediate area of contact. long bones Bones that have a long structural axis such as leg and arm bones as opposed to flat bones such as ribs and shoulder blades. lower airway trachea, bronchi, and alveoli. lumbar spine The lower section of the spine between the thorax and the pelvis.

lymphangitis Spread of a local infection into the lymph system. The early stage of a systemic infection. Symptoms include red streaks running centrally from the site of a local infection. mechanism of injury (MOI) What caused the problem. The MOI can be non-specific, such as “fall from a cliff,” or very specific, such as “com- pensated volume shock due to vomiting and dehy- dration.” mental status Describes the level of brain func- tion in an awake patient (A on AVPU) in terms of memory, orientation, level of anxiety, and behav- ior. middle ear barotrauma Condition in which the air pressure in the middle ear does not match the air pressure outside the middle ear, injuring the ear drum. mid-range position Position in a joint’s range of motion between full extension and full flexion. Also called neutral position. myocardial ischemia Loss of perfusion to heart muscle, usually due to a clot or plaque in a coro- nary artery. myocardial infarction (MI) Loss of perfusion to heart muscle resulting in death of muscle tissue. neurotoxins Toxins that interfere with the func- tion of the nervous system, capable of causing muscle spasm, paralysis, altered sensation, and respiratory distress. neurovascular bundle An artery, vein, and nerve combination routed though the body together. neutral position The position approximately half way between flexion and extension. Also called the mid-range position. normal saline (NS) A fluid used for volume replacement or wound irrigation having the same percentage of salt as the blood and body tissues.